by Wren Downs
To attend his weekly Zoom meetings, one patient at the Center for Hope and Healing addiction treatment facility in Morgantown, drives his ATV four miles down the road and holds his cell phone toward the sky to search for service.
Another patient walks to the local McDonald’s and sits in the parking lot, using the restaurant’s WiFi because he doesn’t have his own at home.
The coronavirus pandemic made things difficult for everyone, but especially for individuals seeking treatment for mental health issues and substance abuse disorders — and especially in rural West Virginia.
Since the start of the pandemic, treatment for mental health and substance abuse disorders has been moved mostly online, but according to the West Virginia Broadband Report, West Virginia ranks 47 out of 50 states in broadband connectivity. In 2017, 30% of residents did not have internet access.
Dawn Staub is an addiction studies professor at West Virginia University and an outpatient therapist at WVU’s Center for Hope and Healing. Staub said internet access has been a big issue for patients at the center, and some people don’t even have devices they can access the internet.
In August, Dr. Rahul Gupta, West Virginia’s chief health officer from 2015-18, said the reliability of telemedicine and the lack of internet access would widen health disparities between the state’s most impoverished communities and wealthier areas.
Professionals are doing all they can to adapt to these new challenges. Facilities like Chestnut Ridge Treatment Center in Morgantown took steps toward solving the internet accessibility issues experienced by many patients seeking treatment for substance abuse disorders. Offices that weren’t being used by therapists — who started working from home — were turned into Zoom rooms where people who don’t have internet access or smartphones can go to participate in online group therapy.
Staub said patients at Center for Hope and Healing are required to take a weekly drug tests when they come for treatment sessions. Because their sessions are now online, they are required to offer a saliva sample on camera, which produces visual results that can be shown and identified via Zoom.
National rates of substance abuse and mental health issues increased during the COVID pandemic. Even before the pandemic, West Virginia had the highest rate of drug overdose deaths in the nation, according to the Centers for Disease Control and Prevention. Adults in West Virginia were reporting symptoms of depression and/or anxiety at the highest rates in the country at the end of March, according to data from the Kaiser Family Foundation.
Despite the statistics showing more need, West Virginia also ranks among the lowest states for providing access to treatment. According to the Substance Abuse and Mental Health Services Administation, 53.1% of adults in West Virginia with mental illness receive no treatment.
Staub moved to West Virginia about four years ago and was shocked to find out the state did not have an inpatient program for treating substance abuse disorders.
“When the Center for Hope and Healing opened up about a year ago, they were the first inpatient rehab in the state,” she said.
Abby Edwards, 23, grew up in Harrisville, a small town in rural Ritchie County. Edwards dealt with mental health issues and post-traumatic stress disorder for much of her life. She was unable to find effective treatment in her hometown and would travel over an hour seeking help.
“There are no therapists that specialize in treating PTSD in my hometown or even in the area,” Edwards said. “Going to WVU gave me the privilege to access better mental health resources than I could back home.”
Because West Virginians were already affected by mental health issues and substance abuse disorders at higher than the national rates, and they had less access to resources for those problems, COVID was particularly damaging.
A big issue, according to Staub, has been the limited capacity for individuals who need to be admitted for inpatient services. Prior to the pandemic, rooms for inpatient care had two beds. COVID decreased the capacity and those rooms became single-bed rooms.
“We now have room for half the number of people to seek out treatment,” said Staub.
When someone at the Center for Hope and Healing tested positive for COVID, the entire unit went on lockdown and new admissions were prohibited.
“Even when patients are able to access the treatment they need, there are other factors that make online treatment more difficult than in-person treatment for many people,” said Staub.
She said she will often catch someone playing video games while in Zoom therapy, or smoking or vaping, which is prohibited in the real-life group room, so it’s also not allowed on Zoom.
“It’s harder for patients to focus on treatment when they are staring at a computer screen for two hours and not in a real-life group therapy session,” she said.
Edwards said when her therapy moved online, she lost control of her drinking.
“I felt less inclined to be on top of my drinking when I was seeing my therapist on Zoom because it took away some of the shame or guilt I would feel internally when I was going to therapy in person,” she said.
Graham Harkins, 23, of Morgantown, has been going to therapy for his anxiety and depression since 2019. He said it was the most necessary during the pandemic as the isolation of quarantine and the increased tension in his family’s household took a toll on his mental health.
Harkins said one of the big disadvantages of Zoom therapy for him has been the potential lack of privacy.
“Luckily I live alone,” he said, “but my apartment walls are really thin. When I’m on the verge of having a breakdown or crying during therapy, I worry about whether my neighbors will hear me and I get embarrassed.”
Hawkins said this leads him to often hold back his emotions when talking to his therapist, which was never a concern for him when he was seeing her in person, in a private room in which he felt more comfortable. He said he appreciates that the pandemic has normalized going to therapy and he feels less alone getting help for problems a lot of people are also struggling with during this time.
In addition to mental health and addiction specialists, other members of the community are trying to fill in the gap left by the absence of in-person contact. Throughout the week there is a sign in the window of Jones United Methodist Church in Morgantown, that reads:
“STEVE IS IN. COME TALK WHENEVER YOU NEED, EVEN IF WE ARE 6 FEET APART AND MUMBLING THROUGH MASKS. I AM HERE FOR YOU.”
Stephen Prince is a pastor at this church, which prior to the pandemic, held in-person Narcotics Anonymous meetings.
“They moved the meetings online, but not everyone can attend the online meetings,” Prince said, “and a lot of people are having a hard time dealing with not being able to access what for some is their only source of support.”
He comes into the church every day, hangs up the sign in the window, and waits for anyone struggling with substance abuse disorders, mental health issues, or “anything under the sun,” as he puts it, to come in for a talk. Inside the church, a fold-out chair is placed 6 feet away from the open door to Prince’s office, so anyone who comes in can sit and talk to him about whatever they are struggling with while remaining COVID-safe.
Prince said this has proven to be a helpful resource and people come by the church to visit him frequently.
“This pandemic has been hard for everyone,” he said, “so I try to make myself available to lend an ear and maybe some friendly guidance if needed. Most people just need someone to be there for them, especially now, and I like to be that person.”
Wren Downs is a student in the WVU Reed College of Media. This article was written as part of the multimedia storytelling capstone class and offered to The Dominion Post for publication.